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Meghan Howell
Professor Jane Blakelock
English 2100, Section 30
20 April 2016
Vaccinations: The Fear of the Unknown
Imagine being a new parent with all the joys and worries that come along with this new
role. One of these worries is a long vaccination list and what shots your child needs and when.
The immunization schedule for children in the United States is expanding (Fraleigh 36). There
also seems to be a growing resistance against vaccinations in the United States; for instance,
[i]n 2014 there was a record high number of measles cases (668) since the disease was
considered eliminated in 2000, with researchers placing the blame on declining vaccination
rates (Mccoy). Why are people refusing life-saving vaccines? This is not an easily answered
question. There are many controversies that surround vaccinations, but the underlining reason for
all of them is fear. Vaccines are made in a scientifically complex way that is difficult to
understand. This lack of knowledge complied with our social media driven culture encourages
paranoia and ignorance on the subject of vaccines. It produces an emotional argument which has
no scientific merit but has real and serious implications. I will briefly look at the history of
vaccines, how they work in laymans terms, then the controversies surrounding them. Lastly, I
will examine solutions to help alleviate the publics fears regarding vaccinations.
Vaccines were developed in the late 1950s and shortly after the Federal government
created the Vaccination Assistance Act. That act started the immunization schedule and in the late
1960s implemented mandatory vaccinations for children to get before they attended school.
Currently in America, all states mandate vaccinations for polio, rubella, measles, and diphtheria

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(Geoboo et al. 529). The school plays a big part in maintaining records and educating parents on
what vaccinations their child needs. Each year the CDC analyzes school vaccination data
collected by federally funded state, local, and territorial immunization programs (Seither et al.
897). These assessments on vaccination coverage, help immunization programs identify clusters
of low coverage and develop partnerships with schools and communities (Seither et al. 897).
This partnership is made to guarantee that children are being safeguarded from diseases that are
vaccine-preventable.
The way vaccines are created is quite scientific so I will only discuss the basic concept
behind how they work. The main goal of vaccinations is to achieve herd immunity which means
that enough people are immune to a disease that transmission chains are broken (Mccoy). They
work by stimulating the individuals immune system, which causes the body to produces
antibodies. Those antibodies protect the vaccinated person from the disease in the future
(Carrillo-Marquez et al. 47). In order to achieve herd immunity vaccination rates must be higher
than ninety percent (Mccoy). Many states have decreased vaccination rates and [i]n Seattle, the
polio vaccination rate (81.4 percent) is lower than in Rwanda (Mccoy). Vaccines contain the
same virus that causes the disease, but that part of it is either killed or weakened. Therefore, it
can no longer cause that specific disease. Most parents interpret this wrong by thinking if the
vaccine has the virus still in it, then there is still a danger their child will get sick. This is not the
case because the virus is not strong enough to attack the immune system (Carrillo-Marquez et al.
47).
Generally speaking, parents are still concerned their child will get sick or have a
complication from a vaccination. In fact, side effects from vaccinations are very rare. The normal
side effects are fever, reddened, swollen or sore injection site; the more serious ones can occur

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with any medication (Fraleigh 38). The chances of a life threatening condition from a vaccine,
such as anaphylactic shock, is less than one in one million (Carrillo-Marquez et al. 48).
Therefore vaccines have a great impact on the health of people, particularly young children. As
the statistics demonstrate, the good vaccines do outweigh their potential to do harm. The
Pediatric Academic Society estimated that 10.5 million cases of infections illness and 33,000
deaths are prevented each year by childhood vaccinations (Carrillo-Marquez et al. 46).
Another reason people refuse vaccinations is rooted in religious and moral matters. Fortyeight states, beside West Virginia and Mississippi, allow for exemption from vaccines based on
religious concerns (Geoboo et al. 530). Refusal to vaccinate because of religious and moral
reasons stems from how some vaccines are made. It is a process in which [t]he initial cell lines
in which vaccine viruses are grown, [are] from voluntarily aborted fetuses (Chatterjee et al.
498). Single-antigen vaccines against rubella, multi-antigen vaccines against MMR, singleantigen vaccine against chicken pox, and vaccines against Hepatitis A are a few made in this
way. The Catholic Church is a religion that opposes abortions but they see the importance of
vaccines and came up with an executive decision. In conclusion, [t]he US Conference of
Catholic Bishops has issued statements relieving parents of the obligation to refuse this vaccine
based on the Catholic Church's opposition to voluntary abortion (Chatterjee et al. 498). Catholic
Bishops explained how vaccination is the only way to protect children and the community from
serious diseases (Chatterjee et al. 498). These moral and religious reasons may have been
addressed by the Catholic Church but people still refuse on an individual basis.
Parents also may fear the safety of vaccinations due to the alleged link between autismspectrum disorders and vaccines. So far the link has not been supported by any scientific
evidence (Chatterjee et al. 497). Some vaccines contain a chemical called thimerosal which

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contains mercury. When the public found out mercury was in the vaccines their children were
receiving there was an outcry for the use of thimerosal to be stopped. In 1999 the American
Academy of Pediatrics (AAP) and the United States Health Service made a decision that caused
the general public opinion to link thimerosal containing vaccines to autism (Chatterjee et al.
497). They made a statement to remove thimerosal from pediatric vaccines. Although, this was a
cautionary position due to the fact that the risks of low-dose ethylmercury in vaccines were
unknown and no evidence showed that it created toxic mercury levels (Chatterjee et al. 497). The
Institute of Medicine did a study and found no link between autism and thimerosal containing
vaccinations; their results are supported by the CDC (Fraleigh 39). Although, the use of
thimerosal has been eliminated from most vaccines since 2000 (Carrillo-Marquez et al. 48-49).
One thing to keep in mind is that the age at which children receive vaccines and the age autism is
usually diagnosed is around the same time. Therefore, two events happening at the same time
does not make them in causation of one another.
The combination vaccine of measles-mumps-rubella (MMR), created fears that it
triggered autism when a 1998 study in London published its results. It was a group of only
twelve children and eight developed autism after having a gastrointestinal disorder. The
researchers attributed the MMR combination vaccination as the cause of those eight children
developing autism. This study was posted in The Daily Telgraph in London exclaiming how
there was a causation link between the vaccine and autism. It generated an uproar and damage
because the use of the MMR dropped in several countries, with subsequent measles and mumps
outbreaks (Fraleigh 39). Since then, researchers have been unable to replicate the results of the
study and the conclusions have been withdrawn. (Fraleigh 39). The damage was done though,
and despite the science parents still fear the unsupported autism-vaccine link. For instance, in

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March 2008 Hannah Polings parents claimed she developed severe neurodevelopmental
problems after receiving the MMR and other vaccines (Chatterjee et al. 497). She was nine
years old and their claim was compensated by the Vaccine Injury Compensation Program
(VICP). This program was developed to reimburse those who felt they were harmed by a
vaccine. However, the VICP only requires a biologically plausible theory and not irrefutable
proof (Chatterjee et al. 498). This story was widely published in news reports which furthered
patients and parents beliefs and fears regarding the MMR vaccine. It also caused more doubts
about the safety of vaccines and more mistrust in the federal and state health programs to
administer them correctly.
Many people do not seem to understand that strong vaccination programs are why many
diseases are considered eliminated in the United States. (Carrillo-Marquez et al. 50). Those who
are vaccinated are immune from a certain a disease, but these diseases are still a major threat. It
would be devastating for them to return, therefore the importance of what vaccines actually do
cannot be stressed enough. A reason some refuse to vaccinate is the Federal and State
immunization schedules are expanding, meaning more vaccinations, which is difficult to keep up
with. For instance, fourteen different vaccines and up to twenty-six injections are suggested for
children by age two (Chatterjee et al. 501). Parents face a big decision which is influenced by
internet blogs and misinformation, profit-driven pharmaceutical companies, and media reports
that fuel their fears and worries (Chatterjee et al. 502). Particularly when there are recalls on
vaccines or shortages, which the media reports about, giving people a reason to mistrust
immunization (Fraleigh 38). For instance, Americans 18 to 29 are very skeptical about the safety
of vaccines, 15 percent think they are unsafe and another 8 percent are unsure (Mccoy). What
this may show is that too many people allow their thinking to be influenced by press such as The

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Daily Telegraph. One article made the suggestion that, [f]ear of disease has shifted to fear of
vaccine safety (Chatterjee et al. 497). Another article proposed the idea that because people
have not had to experience many vaccine-preventable diseases for themselves, such as polio,
they do not understand how devastating the effects can be. This lack of first-hand experience has
contributed to an uneasy relationship between the lay public and stewards of public health
(Chatterjee et al. 497). This refusal to vaccinate, out of fear for safety, will most likely lead to
more outbreaks in the upcoming years (Mccoy).
Science has proven that they do more good than harm. So have vaccines become victims
of their own success [?] (Chatterjee et al. 497). One found that in an article there was a theory,
from an author named Robert Putnam, called social trust which describes, the degree to which
people think others are honest and reliable (Mccoy). In this fast-paced, social media culture
have we become so paranoid that we stop trusting the vaccination schedule because it is a policy
and we no longer trust the ones behind that policy? The [r]esearch shows that in 1966, 73
percent of the population trusted the leaders of the medical profession; by 2012 this has fallen to
34 percent, and less than one-quarter (23 percent) of the population has confidence in the U.S.
health care system as a whole (Mccoy). These surprising numbers show us that the argument
against vaccinations is an emotional one that is driven by mistrust. How do we get these skeptics
to trust again? The facts are out there to prove that vaccines have greatly helped human life.
These patients and parents do not just need facts but someone they trust explaining and
addressing all their concerns and fears regarding vaccinations (Chatterjee et al. 502).
Healthcare providers are in the most influential position to help educate parents on
vaccines and the immunization schedule. There needs to be a partnership between the two that
helps alleviate parents anxieties and correct misconceptions. Before this can happen the

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healthcare provider must take the time to tackle and acknowledge parents fears and answer all
their questions. (Chatterjee et al. 501). They [also] must educate themselves on the latest
scientific research that addresses these issues (Chatterjee et al. 502). Henceforth, there should
be a specific training program for healthcare providers that deals with up to date information on
vaccines and effective communication (Chatterjee et al. 502).
A new program to help parents with making sure their child is up to date on their
vaccines is being conducted and studied in Kentucky. A news article explained how a group of
pediatricians from the University Of Kentucky College Of Medicine have created a new textmessage alert system for parents to remember their childs vaccine appointments. In Kentucky
about one-third of children are not up to date on the vaccine schedule recommended by the CDC.
Research in Kentucky shows that most parents actually are not refusing vaccines but instead are
just forgetting. The text message is sent out a week before the childs vaccine appointment. The
study is being overseen by three doctors and it is following 1,000 patients with 500 children. The
preliminary results are showing that parents who received the text messages kept their
appointments and got their children vaccinated (Text Message Alerts Keep More Kentucky
Children Up-to-Date with Vaccinations). Perhaps this is how to establish a trusting relationship
between the healthcare professionals and the parents by communicating on a more individual
basis. If this study continues to have success this may become part of the vaccine process and
could be implemented in other areas around the United States.
After analyzing the debates regrading vaccinations I have come to the conclusion that
parents refusal to vaccinate is due to deep-rooted emotional fears. Also not being educated on
how vaccines work in the body and the scientific evidence that shows they do more good than
harm. In my own opinion it is up to healthcare providers to commit the time to educate parents

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and confront the controversies head on to ease their fears and worries (Chatterjee et al. 502).
Immunization needs to be taken more seriously or we will see these devastating diseases make a
comeback.

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Works Cited
Carrillo-Marquez, Maria, and Lisa White. Current Controversies In Childhood Vaccination.
South Dakota Medicine: The Journal Of The South Dakota State Medical Association
Spec no. (2013): 46-51. MEDLINE with Full Text. Web. 11 Feb. 2016.
Chatterjee, A, and C O'Keefe. "Current Controversies In The USA Regarding Vaccine Safety."
Expert Review Of Vaccines 9.5 (n.d.): 497-502. Science Citation Index. Web. 24 Feb.
2016.
Fraleigh, JM. Vaccination: Compliance Controversy. Rn 72.5 (2009): 36-40 5p. CINAHL Plus
with Full Text. Web. 28 Jan. 2016.
McCoy, Charles. Are US vaccine rates going down because public trust and social ties are
eroding? The Conversation. Andrew Jaspan. 24 July 2015. Web. 8 February 2016
Seither, Ranee, et al. "Vaccination Coverage Among Children In Kindergarten - United States,
2014-15 School Year." MMWR. Morbidity And Mortality Weekly Report 64.33 (2015):
897-904. MEDLINE with Full Text. Web. 9 Mar. 2016.
Song, Geoboo, Carol L. Silva, and Hank C. Jenkins-Smith. Cultural Worldview And Preference
For Childhood Vaccination Policy. Policy Studies Journal 42.4 (2014): 528-554.
Political Science Complete. Web. 28 Jan. 2016.
Text Message Alerts Keep More Kentucky Children Up-to-Date with Vaccinations. Plus
Media Solutions U.S Official News 14 April (2015). LexisNexis Academic. 18 February
2016.

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